Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Haploidentical TCR A/B and B-cell depleted hematopoietic SCT in pediatric SAA and aspergillosis

Bone Marrow Transplantation volume 49, pages 847–849 (2014)Cite this article

Subjects

Children with acquired SAA (ASAA) are at high risk of life-threatening infections without prompt therapy.1 The gold standard treatment is hematopoietic SCT (HSCT) from a matched sibling donor, available in only 25% of cases, with a survival rate of 90%.2 The remaining patients are eligible for immunosuppressive treatment (IST) with a response rate of 60–80%.3 In cases of IST failure and absence of suitable donor, haploidentical HSCT (HHSCT) could be considered. To date, limited reports of the use of purified CD34+ cells are available.2,4,5 In this setting, graft rejection (GR) and opportunistic infection due to delayed immune reconstitution are major causes of transplant failure.4

A 4-year-old African girl was admitted to the Pediatric Hematology Oncology of Padova with fever, bruises, severe pancytopenia and reticulocytopenia. The diagnosis of ASAA was made through BM aspirate (aplasia without myelodysplasia) and trephine biopsy (<10% of cellularity without myelofibrosis).1

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Marsh JCW, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC et al. Guidelines for the diagnosis and management of aplastic anemia. Br J Haematol 2009; 147: 43–70.

    Article  CAS  Google Scholar 

  2. Passweg J, Perez W, Eapen M, Camitta BM, Gluckman E, Hinterberger W et al. Bone marrow transplantation from mismatched related and unrelated donors for severe aplastic anemia. Bone Marrow Transplantat 2006; 37: 641–649.

    Article  CAS  Google Scholar 

  3. Locasciulli A, Oneto R, Bacigalupo A, Socié G, Korthof E, Bekassy A et al. Outcome of patients with acquired aplastic anemia given first line bone marrow transplantation or immunosuppression treatment in the last decade: a report from the European Group for Blood and Marrow Transplantation (EBMT). Haematologica 2007; 91: 11–18.

    Article  Google Scholar 

  4. Wang Z, Yan H, Zhu L, Wang H . Successful unmanipulated stem cell transplantation from HLA-haploidenitcal 3-loci-mismatched parents in two children with severe aplastic anemia not responding to immunosuppressive therapy. Am J Hematol 2010; 85: 389–390.

    Article  Google Scholar 

  5. Koh KN, Im HJ, Kim BE, Choi ES, Jang S, Kwon SW et al. Haploidentical haematopoietic stem cell transplantation using CD3 or CD3/CD19 depletion and conditioning with fludarabine, cyclophosphamide and antithymocyte globulin for acquired severe aplastic anaemia. Br J Haematol 2012; 157: 139–142.

    Article  Google Scholar 

  6. Schumm M, Lang P, Bethge W, Faul C, Feuchtinger T, Pfeiffer M et al. Depletion of T-cell receptor alpha/beta and Cd19 positive cells from apheresis products with the CliniMACS device. Cytotherapy 2013; 15: 1253–1258.

    Article  CAS  Google Scholar 

  7. Urban C, Benesch M, Sovinz P, Sipurzynski S, Lackner H, Müller E et al. Alternative donor HSCT in refractory acquired aplastic anemia - prevention of graft rejection and graft versus host disease by immunoablative conditioning and graft manipulation. Pediatr Transplant 2012; 16: 577–581.

    Article  CAS  Google Scholar 

  8. Lang P, Mueller I, Greil J, Bader P, Schumm M, Pfeiffer M et al. Retransplantation with stem cells from mismatched related donors after graft rejection in pediatric patients. Blood Cells Mol Dis 2008; 40: 33–39.

    Article  Google Scholar 

  9. Bacigalupo A, Socie' G, Lanino E, Prete A, Locatelli F, Locasciulli A et al. Fludarabine, cyclophosphamide, antithymocyte globulin, with or without low dose total body irradiation, for alternative donor transplants, in acquired severe aplastic anemia: a retrospective study from the EBMT-SAA Working Party. Haematologica 2010; 95: 976–982.

    Article  CAS  Google Scholar 

  10. Lee YH, Kim JY, Choi BO, Ryu MR, Chung SM . Total lymphoid irradiation based conditioning for hematopoietic stem cell transplantation in severe aplastic anemia. Radiat Oncol J 2012; 30: 165–172.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Pediatric Hematology Oncology, Transplantation Unit, University of Padova, Padova, Italy,

    M Tumino, C Mainardi, M Pillon, E Calore, M V Gazzola, R Destro, A Strano, S Varotto, F Gregucci, G Basso & C Messina

Authors
  1. M Tumino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C Mainardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Pillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E Calore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M V Gazzola
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Destro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A Strano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S Varotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. F Gregucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. G Basso
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C Messina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Tumino.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tumino, M., Mainardi, C., Pillon, M. et al. Haploidentical TCR A/B and B-cell depleted hematopoietic SCT in pediatric SAA and aspergillosis. Bone Marrow Transplant 49, 847–849 (2014). https://doi.org/10.1038/bmt.2014.58

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2014.58

This article is cited by

Search

Advanced search

Quick links